Sex and Coronary Artery Disease (CAD)

A usual question is asked by the patient about the performance of sex. One may lead a fairly normal life in this regard, of course with precautions. However, it depends upon the severity of the lesion of CAD. As a rough guide, following a recovery from a heart attack, if the patient is able to climb one, preferably two full flight of stairs without any feeling of discomfort, he may indulge in coitus. More precisely, the heart rate should not be more than 120 per minute during the period of sex, and the patient should have no pain/discomfort.

To avoid additional stress, sex should be avoided immediately after meals, and even extra-marital sex should be abstained from. If suitable precautions are not taken, or the lesion happens to be more severe, an attack of angina may be precipitated during sex, and one may have to keep a quick-acting coronary dilator i.e. glyceryl trinitrate under the tongue (or chewed). If severe pain occurs during sex, follow the steps of first-aid treatment for heart attacks.

Although rare, an unaware patient may even die in orgasm, i.e. during the climax of a sexual excitement, the so-called coital death. The idea of writing this is only that such type of exertion should be kept in mind by the concerned patient. It is an important step of secondary, or even primary prevention, especially in highrisk cases. In any case, the patient should not feel hesitant to ask any questions in this regard from his physician I family doctor. He should also not feel embarrassed to discuss with his physician, in case he has any problems during the the performance of sex.

From the above account of prevention of CAD, it is evident that both primary and secondary steps of prevention are necessary to keep the fast-increasing cases of CAD under control, thus saving people both from morbidity and mortality.